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Lessons From an Outbreak: How Ebola Shaped 2014

Interviews with experts on what to take away from the devastation of the disease.

THE ATLANTIC   by Julie Beck                                                                                                 Dec. 17, 2014

...While some in the Western media criticized West Africans' fear of health workers and resistance to public-health measures, the United States got a small taste of Ebola panic when Thomas Eric Duncan became the first case diagnosed in the country in September, followed by three other cases this fall. Duncan was the only patient to die in the U.S., and the panic died down quietly.

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Challenges in Responding to the Ebola Epidemic — Four Rural Counties, Liberia, August–November 2014

 

                CDC Morbidity and Mortality Weekly Report (MMWR)                                                                   

 by Aimee Summers, PhD1,2, Tolbert G. Nyenswah, MPH 3, Joel M. Montgomery, PhD2,4, John Neatherlin, MPH2,4,       Jordan W. Tappero, MD                                                                                                              Dec. 16, 2014

...The Ebola epidemic in Liberia presents unique challenges not only from its spread into crowded urban environments (10) but also its occurrence in remote communities. As in urban counties, county and district health teams in rural counties with remote regions need adequate training in 1) case reporting; 2) case investigation; 3) case management; 4) contact tracing; 5) safe burials; 6) safe collection, processing, and transport of blood specimens for testing; and 7) development of a county-level incident management system.

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Screening Test Finds Drugs That Show Promise Against Ebola

U.S. NEWS AND WORLD REPORT HEALTH TODAY   by   Dennis Thompson                            Dec. 17, 2014

A screening test has identified more than 50 drugs that could be helpful in treating people with Ebola, researchers report.

"These drugs are all approved (by the FDA) so they could be deployed quickly if follow-up research proves that they are effective," said study author Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute with the Icahn School of Medicine at Mount Sinai in New York City.

The study was published online Dec. 17 in the journal Emerging Microbes and Infections.

The screening test involves a laboratory-engineered fake Ebola virus. The fake virus contains two proteins from the deadly pathogen, but does not include the infectious genetic material that makes Ebola so dangerous, Garcia-Sastre said.

Read complete story.

http://health.usnews.com/health-news/articles/2014/12/17/screening-test-finds-drugs-that-show-promise-against-ebola

Read Emerging Microbes and Infections paper.

http://www.nature.com/emi/journal/v3/n12/full/emi201488a.html

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Ebola: UN says health workers in Sierra Leone to receive hazard pay using mobile money

UNITED NATIONS NEWS CENTRE                                                                                            Dec. 16, 2014
Response workers battling the Ebola outbreak in West Africa will receive “hazard pay” for the first time in Sierra Leone using mobile money because “unless there is a certain element of incentives, or danger pay, it’s very difficult to attract and retain people,” the United Nations Development Programme (UNDP) announced today.


Ambulance depot near an emergency response centre, in Freetown, Sierra Leone. Ambulances and drivers have to be disinfected after each trip carrying suspected Ebola cases. UN Photo/Martine Perret

“One of the most difficult things about tackling the Ebola crisis is in the area of human resources,” said Sudipto Mukerjee, UNDP’s Country Director for Sierra Leone. “You can construct a treatment centre in a couple of months. You can construct a community care centre in two to three weeks. But getting trained people to come and run them has been a major challenge.”

The transition from direct cash to an electronic solution will help to improve overall efficiency, timeliness and security of payments for Ebola response workers, Mr. Mukerjee said.

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Ebola outbreak: Sierra Leone announces house-to-house searches

BBC                                                                                                                         Dec. 17, 2014

Sierra Leone is due to mount house-to-house searches in the capital Freetown to find hidden cases of Ebola.

President Ernest Bai Koroma also said that Sunday trading would be banned and travel between districts restricted.

The measures come after the authorities banned all public celebrations of Christmas and New Year in a bit to tackle the virus...

In his statement, President Koroma said the searches aimed to "break the chain of transmission", the AFP news agency reported.

He added: "Do not hide the sick".
http://www.bbc.com/news/world-africa-30511208?utm_source=December+17+2014+EN&utm_campaign=12%2F17%2F2014&utm_medium=email

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Morbidity and Mortality Weekly Report (MMWR)

Update: Ebola Virus Disease Epidemic — West Africa, December 2014

CDC                                                                                                                         Dec. 16, 2014

...There were 4,281 new Ebola cases reported during the 4-week period of November 9–December 6, compared with the 2,705 new cases reported during the 3-week period of October 19–November 8.. Cases were widely distributed geographically among districts in all three countries, with the prefecture of Mamou in Guinea reported to be newly affected.

During both periods, counts of reported Ebola cases were highest in the area around Monrovia, including Grand Cape Mount, Liberia; the Western Area and northwest districts of Sierra Leone, particularly Bombali and Port Loko; and Conakry, Guinea .

Read Complete report.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1216a1.htm?s_cid=mm63e1216a1_x

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Here’s How Much the Next Ebola Will Cost Us

Why saving the environment can help prevent it

TIME MAGAZINE     by Alexandra Sifferlin                                                                         Dec. 16, 2014

The global community cannot withstand another Ebola outbreak: The World Bank estimates the two-year financial burden price tag of the current epidemic at $32.6 billion. Unfortunately, the virus has revealed gaping holes in our preparedness for major infectious disease epidemics. Because of these, plus the urbanization of rural communities and globalization of travel and trade, more of these epidemics are expected.

In a new report from the EcoHealth Alliance published in the journal Proceedings of the National Academy of Sciences (PNAS), experts estimate that the world will see about five new emerging infectious diseases each year and that we need new prevention strategies to cut economic losses.

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For Ebola Patients in Sierra Leone, Survival Takes More Than Medicine

WIRED             by Erika Check Hayden                                                                                         Dec. 16, 2014

BO, Sierra Leone—Morning rounds have just begun at an Ebola treatment center here in the city of Bo, in central Sierra Leone.

An Ebola management center run by Doctors Without Borders in Bo, Sierra Leone.  Erika Check Hayden

The patients who are able shuffle out of a tent towards two layers of chain-link fence that separate them from the outside—2 meters minimum distance. Some clutch bottles of water, bright orange soda, or foil-wrapped nutritional bars. A woman in an orange printed wrap skirt lags behind the others, struggling to slide a sandal on to her foot. She came here in bad shape with her husband and three children, but she is improving; she was recently taken off intravenous fluids....

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Endless Ebola Epidemic? That's The 'Risk We Face Now,' CDC Says

NATIONAL PUBLIC RADIO  by Michaeleen Doucleff                                                               Dec. 16, 2014

Speed. That's key to ending the Ebola epidemic, says the director of the U.S. Centers for Disease Control and Prevention.

Dr. Thomas Frieden is visiting West Africa this week to figure out how to reduce the time it takes to find new Ebola cases and isolate them.

Otherwise, Ebola could become a permanent disease in West Africa.

 

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, talks with Doctors Without Borders staff during a visit in August to an Ebola treatment center in Monrovia, Liberia. Tommy Trenchard for NPR

"That's exactly the risk we face now. That Ebola will simmer along, become endemic and be a problem for Africa and the world, for years to come," Frieden tells NPR. "That is what I fear most."

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Fewer Ebola Cases Go Unreported Than Thought, Study Finds

NEW YORK TIMES    by Donald G. McNeil, Jr.                                                                 Dec. 16, 2014

Transmission of the Ebola virus occurs mostly within families, in hospitals and at funerals, not randomly like the flu, Yale scientists said Tuesday, and far fewer cases go unreported than has previously been estimated.

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